This Essay examines the elegantly simple idea that consent to medical treatment or participation in human research must be “informed” to be valid. It does so by using as a case study the controversial clinical research trial known as the Surfactant, Positive Pressure, and Oxygenation Randomized Trial. The Essay begins by charting, through case law and the adoption of the common rule, the evolution of duties to secure fully informed consent in both research and treatment. The Essay then utilizes the (...) SUPPORT study, which sought to pinpoint the level of saturated oxygen that should be provided to extremely low birth weight infants to demonstrate modern complexities and shortcomings of the duty to secure informed consent. This Essay shows how the duty is measured by foreseeability of risks and benefits in human research and why federal regulators believed the tradeoffs in risk and benefits from differing oxygen levels administered in the support study were foreseeable. It then explores the contours of the duty to secure informed consent when applied to researchers who also serve as treating physicians, highlighting how common law duties differ in jurisdictions that apply the professional standard and those that apply the patient-centered material risk standard. This Essay provides new insight into what the law must do to make real the notion that [e]very human being of adult years and sound mind has a right to determine what shall be done with his body.”. (shrink)

From Ancient Greek times, music has been seen as a mathematical art, and the relationship between mathematics and music has fascinated generations. This collection of wide ranging, comprehensive and fully-illustrated papers, authored by leading scholars, presents the link between these two subjects in a lucid manner that is suitable for students of both subjects, as well as the general reader with an interest in music. Physical, theoretical, physiological, acoustic, compositional, and analytical relationships between mathematics and music are unfolded and explored (...) with focus on tuning and temperament, the mathematics of sound, bell-ringing and modern compositional techniques. (shrink)

Newborn bloodspot screening programs are some of the longest running population screening programs internationally. Debate continues regarding the need for parents to give consent to having their child screened. Little attention has been paid to how meanings of consent-related terminology vary among stakeholders and the implications of this for practice. We undertook semi-structured interviews with parents, healthcare professionals and policy decision makers in two Canadian provinces. Conceptions of consent-related terms revolved around seven factors within two broad domains, decision-making and information (...) attainment. Decision-making comprised: parent decision authority; voluntariness; parent engagement with decision-making; and the process of enacting choice. Information ascertainment comprised: professional responsibilities ; parent responsibilities; and the need for discussion and understanding prior to a decision. Our findings indicate that consent-related terms are variously understood, with substantive implications for practice. We suggest that consent procedures should be explained descriptively, regardless of approach, so there are clear indications of what is expected of parents and healthcare professionals. Support systems are required both to meet the educational needs of parents and families and to support healthcare professionals in delivering information in a manner in keeping with parent needs. (shrink)

Though John Stuart Mill's long employment by the East India Company did not limit him to drafting despatches on relations with the princely states, that activity must form the centrepiece of any satisfactory study of his Indian career. As yet the activity has scarcely been glimpsed. It produced, on average, about a draft a week, which he listed in his own hand. He subsequently struck out items that he sought to disown in consequence of substantial revisions made by the Company's (...) directors or the Board of Control. He also listed items that achieved publication as parliamentary papers and they amount to about ten per cent of his drafts. The two lists, published in the most recent volume of his Collected Works, reveal, at the least, the ‘political’ despatches from which he did not seek to dissociate himself. The despatches were not entirely his work and authorship in the conventional sense may not be assumed. They were the product of an elaborate process, in which many hands were engaged. At worst, they were his work in much the same way that an Act of Parliament is the work of the Crown Solicitor who drafts the bill. At best they were his as are the drafts of a civil servant who believes in policy statements that he prepares for his political masters. The greatest English philosopher and social scientist of the nineteenth century was, in his daily occupation, an employee. His Company was charged with initiating policies for the Indian states and they were subject to the control of a minister of the Crown. (shrink)

A far-reaching and influential view in evolutionary biology claims that species are cohesive units held together by gene flow. Biologists have recognized empirical problems facing this view; after sharpening the expression of the view, we present novel conceptual problems for it. At the heart of these problems is a distinction between two importantly different concepts of cohesion, what we call integrative and response cohesion. Acknowledging the distinction problematizes both the explanandum of species cohesion and the explanans of gene flow that (...) are central to the view we discuss. We conclude by tracing four broader implications for the study and conceptualization of species. (shrink)

Despite its importance, the linkage between genetic and cultural evolution has until now been little explored. An understanding of this linkage is needed to extend evolutionary theory so that it can deal for the first time with the phenomena of mind and human social history. We characterize the process of gene-culture coevolution, in which culture is shaped by biological imperatives while biological traits are simultaneously altered by genetic evolution in response to cultural history. A case is made from both theory (...) and evidence that genetic and cultural evolution are inseverable, and that the human mind has tended to evolve so as to bias individuals toward certain patterns of cognition and choice rather than others. With the aid of mathematical models we trace the coevolutionary circuit: The genes prescribe structure in developmental pathways that lay down endocrine and neural systems, imposing regularities in the development of cognition and behavior; these regularities translate upward into holistic patterns of culture, which can be predicted in the form of probability density distributions ; natural selection acts within human history to favor certain epigenetic rules over others; and the selection alters the frequencies of the underlying genes. The effects of genetic and cultural changes reverberate throughout the circuit and are consequently tested with the passage of each life cycle. In addition to modeling gene-culture coevolution, we apply methods from island biogeography and information theory to examine the cultural capacity of the genes, the factors determining the magnitude of cultural diversity, and the possible reasons for the uniqueness of the human achievement. (shrink)

Originally published in 1973 the editors of this book collected together those studies which had been considered at the time to yield the best evidence in support of Freudian theory, and found on close examination that they failed to provide any such proof. Each paper is printed in full and is followed by a critical discussion which raises questions of statistical treatment, sufficiency of controls and alternative interpretations. The particular usefulness of this format is that it allows readers to form (...) their own opinions while providing helpful suggestions and guidelines on how to approach experimental studies with a critical mind. (shrink)

Enhancer detectors are DNA constructs which, when introduced into a eukaryotic genome, respond to nearby genomic transcriptional regulatory elements by means of a reporter gene, revealing the expression pattern of genes in their vicinity. Recent experiments in Drosophila suggest that enhancer detection is a powerful method to identify genes that are expressed in the nervous system. Since enhancer detectors allow a rapid molecular and genetic characterization of genes in their vicinity, the method will greatly facilitate the study of neural development (...) and behavior. (shrink)

Despite its importance, the linkage between genetic and cultural evolution has until now been little explored. An understanding of this linkage is needed to extend evolutionary theory so that it can deal for the first time with the phenomena of mind and human social history. We characterize the process of gene-culture coevolution, in which culture is shaped by biological imperatives while biological traits are simultaneously altered by genetic evolution in response to cultural history. A case is made from both theory (...) and evidence that genetic and cultural evolution are inseverable, and that the human mind has tended to evolve so as to bias individuals toward certain patterns of cognition and choice rather than others. With the aid of mathematical models we trace the coevolutionary circuit: The genes prescribe structure in developmental pathways that lay down endocrine and neural systems, imposing regularities in the development of cognition and behavior; these regularities translate upward into holistic patterns of culture, which can be predicted in the form of probability density distributions ; natural selection acts within human history to favor certain epigenetic rules over others; and the selection alters the frequencies of the underlying genes. The effects of genetic and cultural changes reverberate throughout the circuit and are consequently tested with the passage of each life cycle. In addition to modeling gene-culture coevolution, we apply methods from island biogeography and information theory to examine the cultural capacity of the genes, the factors determining the magnitude of cultural diversity, and the possible reasons for the uniqueness of the human achievement. (shrink)

The subjective effects and therapeutic potential of the shamanic practice of journeying is well known. However, previous research has neglected to provide a comprehensive assessment of the subjective effects of shamanic-like journeying techniques on non-shamans. Shamanic-like techniques are those that demonstrate some similarity to shamanic practices and yet deviate from what may genuinely be considered shamanism. Furthermore, the personality traits that influence individual susceptibility to shamanic-like techniques are unclear. The aim of the present study was, thus, to investigate experimentally the (...) effect of shamanic-like techniques and a personality trait referred to as "ego boundaries" on subjective experience including mood disturbance. Forty-three non-shamans were administered a composite questionnaire consisting of demographic items and a measure of ego boundaries (i.e., the Short Boundary Questionnaire; BQ-Sh). Participants were randomly assigned to one of three conditions: listening to monotonous drumming for 15 minutes coupled with one of two sets of journeying instructions; or sitting quietly with eyes closed for 15 minutes. Participants' subjective experience and mood disturbance were retrospectively assessed using the Phenomenology of Consciousness Inventory (PCI) and the Profile of Mood States-Short Form, respectively. The results indicated that there was a statistically significant difference between conditions with regard to the PCI major dimensions of visual imagery, attention and rationality, and minor dimensions of imagery amount and absorption. However, the shamanic-like conditions were not associated with a major reorganization of the pattern of subjective experience compared to the sitting quietly condition, suggesting that what is typically referred to as an altered state of consciousness effect was not evident. One shamanic-like condition and the BQ-Sh subscales need for order, childlikeness, and sensitivity were statistically significant predictors of total mood disturbance. Implications of the findings for the anthropology of consciousness are also considered. (shrink)

In response to its current crisis, scholars call for the revitalisation of democracy through democratic innovations. While they make ample use of life metaphors describing democracy as a living organism, no comprehensive understanding of ‘life’ has been established within democratic theory. The Black Lives Matter (BLM) movement articulates the urgency of refocusing on life and its meaning through radical democratic practice. This article employs a grounded theory approach, enriched with participatory methods, to develop a radical democratic concept of life in (...) conversation with BLM. It conceptualises life as the existence of a perspective that constantly transforms through its fundamental interconnectedness. Building on this concept, the article outlines four principles of a living democracy that go beyond the revitalisation discourse. A living democracy (1) safeguards the existence of all humans and nonhumans, (2) nurtures a diversity of perspectives, (3) fosters social and planetary connectivity, and (4) enables self- and collective transformation. (shrink)

The view that it is better for life to be created free of disability is pervasive in both common sense and philosophy. We cast doubt on this view by focusing on an influential line of thinking that manifests it. That thinking begins with a widely-discussed principle, Procreative Beneficence, and draws conclusions about parental choice and disability. After reconstructing two versions of this argument, we critique the first by exploring the relationship between different understandings of well-being and disability, and the second (...) by more briefly focusing on the idea of a significant reason. By placing these results against the broader historical and ongoing contexts in which the lives of those with disabilities have been deemed of inferior quality, we conclude with a call for greater humility about disability and well-being in thought and practice. (shrink)

Within any organization (e.g. a hospital or clinic) the perception of the way things operate may vary dramatically as a function of one’s location in the organizational hierarchy as well as one’s professional discipline. Interorganizational variability depends on organizational coherence, safety, and stability. In this four-nation (Canada, Ireland, Australia, and Korea) qualitative study of 42 nurses, we explored their perception of how ethical decisions are made, the nurses’ hospital role, and the extent to which their voices were heard. These nurses (...) suggested that their voices were silenced (often voluntarily) or were not expressed in terms of ethical decision making. Finally, they perceived that their approach to ethical decision making differed from physicians. (shrink)

Most academic papers on ethics in pandemics concentrate on the duties of healthcare professionals. This paper will consider non-professional healthcare workers: do they have a moral obligation to work during an influenza pandemic? If so, is this an obligation that outweighs others they might have, e.g., as parents, and should such an obligation be backed up by the coercive power of law? This paper considers whether non-professional healthcare workers—porters, domestic service workers, catering staff, clerks, IT support workers, etc.—have an obligation (...) to work during an influenza pandemic. It uses data collected as part of a study looking at the attitudes of healthcare workers to working during a pandemic to suggest the philosophical arguments explored. These include: being in a position to do good, the ethics of work, competing obligations to family members and in particular to children and the obligations of citizens in a state of national emergency. We also look at whether compulsory measures are justified to support a national health service during a health emergency. We conclude that even if they are, compulsion should not be restricted to non-professionals who happen to be working in the health service at the time. Rather, compulsion involving a larger pool of people with the relevant skills and abilities is more equitable. (shrink)

The impressive variation amongst biological individuals generates many complexities in addressing the simple-sounding question what is a biological individual? A distinction between evolutionary and physiological individuals is useful in thinking about biological individuals, as is attention to the kinds of groups, such as superorganisms and species, that have sometimes been thought of as biological individuals. More fully understanding the conceptual space that biological individuals occupy also involves considering a range of other concepts, such as life, reproduction, and agency. There has (...) been a focus in some recent discussions by both philosophers and biologists on how evolutionary individuals are created and regulated, as well as continuing work on the evolution of individuality. (shrink)